TN 2 (08-23)

DI 23515.010 Disability Determination Services (DDS) SSA-831 and Notice Completion for Non-Citizen Cases

A. How to complete the SSA-831

Complete the SSA-831 (Disability Determination and Transmittal) for any Title XVI claim per DI 26510.000 with the following exceptions:

Item Action

15 See DI 23515.005D for onset date instruction

18B Same date as item 15

27 Be alert that change in onset is determined from the alleged onset of disability, not the filing date, as in regular Title XVI claims.

B. How to complete rationales and notices

1. Rationale preparation

Use the same requirements for technical rationales as in regular Title XVI claims. For information on rationale preparation and requirements, see DI 26515.001.

2. Notice preparation

  • Non-citizen

Do not release a personalized disability notice (PDN) in unfavorable determinations.

Prepare a PDN and place the PDN in the file.

The field office (FO) sends the PDN as part of to an overall non-citizen denial notice. The FO releases an overall notice of determination, including information about the disability determination.

  • Aged non-citizen age 65 and older

The disability determination is only one of the criteria for eligibility. Do not release a personalized disability notice in unfavorable determinations.

Prepare a PDN and place the PDN in the file.

The FO sends the PDN as part of to an overall non-citizen denial notice. The FO releases an overall notice of determination, including information about the disability determination.

3. Preparing the PDN

Use the same requirements for PDNs as in regular Title XVI claims.

C. Exhibits for non-citizen cases

Exhibit 1 (model language for DDS letter to DHS)

DDS Letterhead

Department of Homeland Security District Office

(Address)

We are writing to obtain medical evidence on behalf of (claimant's name and address) who has applied for payments based on disability or blindness under the Supplemental Security Income provision of title XVI of the Social Security Act. This agency is responsible for determining, on behalf of the Commissioner of the Social Security Administration, whether the claimant is disabled or blind and whether the onset of disability or blindness occurred before or after admission to the United States for permanent residence.

To make such a determination, we need a copy of Form OF-157 (Medical Examination of Visa Applicants) and/or any other medical reports contained in your file. The claimant's authorization is enclosed.

 

The claimant was admitted to the United States for permanent residence on _______ (date), at ________ (place of entry) and was going to live at ­­­­­­­­­­­­_________ (address). His or her non-citizen registration number is       .

 

Your prompt response will help assure a speedy decision on this claim. If you have any questions, please call this agency collect. Thank you for your cooperation.

Sincerely yours,

Chief Medical Consultant

Enclosure

Exhibit 2 – Disability Determination Notice – Non Citizens Age 65 and Older [

(Claimant Name)(SSN)

INFORMATION ABOUT THE DISABILITY DECISION

The Decision on Your Case

(For personalized disability explanation instructions, see DI 26530.000)

About the Decision

Doctors and other trained staff looked at your case and made this decision. They work for the State but used our rules.

Please remember that there are many disability programs, both government and private, that use different rules. A person may be receiving benefits under another program and still not be entitled under our rules. This may be true in your case.

The Disability Rules

You must meet certain rules to qualify for SSI payments based on disability. Your health problems must:

keep you from doing any kind of substantial work (described below), and

last, or be expected to last, for at least 12 months in a row, or

be expected to result in death

You must meet certain rules to qualify for SSI payments based on blindness.

Your eyesight must be no better than 20/200 in the better eye with the use of a corrective lens, or

Your visual fields must be restricted to 20 degrees or less.

You can qualify for SSI benefits due to blindness even if you can do substantial work.

Information About Substantial Work

Generally, substantial work is physical or mental work you are paid to do. Work can be substantial even if it is part-time. To decide if your work is substantial, we consider the nature of the job duties, the skills and experience you need to perform the job, and your earnings.

Usually, we find that your work is substantial, if your gross earnings average over $1000 per month after we deduct allowable amounts. Your work may be different from your work before your health problems began. It may not be as hard to do and your pay may be less. However, we may still find that your work is substantial under our rules.

If you are self-employed, we consider the kind and value of your work, including your part in the management of the business, as well as your income, to decide if your work is substantial.

Exhibit 3 (map of DHS regional and district areas)

map of DHS regional and district areas

Exhibit 4 (DHS regional offices)

DHS Region

Office Address

Eastern Region (BUR)

Burlington, Vermont 05401

Federal Building

Elmwood Avenue

Northern Region (STP)

Twin Cities, Minnesota 55111

Bishop Henry Whipple

Federal Building

Fort Snelling

Southern Region (DLS)

Dallas, Texas 75270

Skyline Center

Building C

311 North Stemmons Freeway

Western Region (SPD)

San Pedro, California 90731

Terminal Island

Exhibit 5 (DHS servicing offices by state)

State

DHS DO Number

DHS Regional Office

Alabama

26

Southern

Alaska

32

Northern

Arizona

18

Western

Arkansas

28

Southern

California

13, 16, 39

Western

Colorado

19

Northern

Connecticut

23

Eastern

Delaware

4

Eastern

D.C.

25

Eastern

Florida

6

Southern

Georgia

26

Southern

Hawaii

17

Western

Idaho

30

Northern

Illinois

9

Northern

Indiana

9

Northern

Iowa

29

Northern

Kansas

11

Northern

Kentucky

28

Southern

Louisiana

28

Southern

Maine

22

Eastern

Maryland

5

Eastern

Massachusetts

2

Eastern

Michigan

8

Northern

Minnesota

10

Northern

Mississippi

28

Southern

Missouri

11

Northern

Montana

30

Northern

Nebraska

29

Northern

Nevada

13

Western

New Hampshire

2

Eastern

New Jersey

21

Eastern

New Mexico

15

Southern

New York

3,7

Eastern

North Carolina

26

Southern

North Dakota

10

Northern

Ohio

24

Northern

Oklahoma

20

Southern

Oregon

31

Northern

Pennsylvania

4

Eastern

Puerto Rico

27

Eastern

Rhode Island

2

Eastern

South Carolina

26

Southern

South Dakota

10

Northern

Tennessee

28

Southern

Texas

14, 15, 20, 38

Southern

Utah

19

Northern

Vermont

1

Eastern

Virginia

25

Eastern

Washington

12

Northern

West Virginia

4

Eastern

Wisconsin

9

Northern

Wyoming

19

Northern

Wisconsin

9

Northern

Wyoming

19

Northern

Exhibit 6 (DHS district offices)

DHS District Offices

 

DO Abbrev.

Office

 2

(BOS)

Boston, Massachusetts 02203

John Fitzgerald Kennedy

Federal Building

Government Center

 3

(NYC)

New York, New York 10278

26 Federal Plaza

 4

(PHI)

Philadelphia, Pennsylvania

19106

Room 1321 U.S. Courthouse

Independence Mall West

601 Market Street

 5

(BAL)

Baltimore, Maryland 21201

E.A. Garmatz Federal Bldg.

101 West Lombard Street

 6

(MIA)

Miami, Florida 33138

7880 Biscayne Blvd.

 7

(BUF)

Buffalo, New York 14202

68 Court Street

 8

(DET)

Detroit, Michigan 48207

Federal Bldg.

333 Elliot St.

 9

(CHI)

Chicago, Illinois 60604

Dirksen Federal Office Bldg.

219 South Dearborn St.

 10

(SPM)

St. Paul, Minnesota 55101

927 New Post Office Bldg.

180 N. Kellogg Blvd.

 11

(KAN)

Kansas City, Missouri 64106

Suite 1100, 324 E. Eleventh St.

 12

(SEA)

Seattle, Washington 98134

815 Airport Way, South

 13

(SFR)

San Francisco, California 94111

Appraisers Bldg.

630 Sansome Street

 14

(SNA)

San Antonio, Texas 78206

Suite A301

U.S. Federal Bldg.

727 East Durango

 15

(ELP)

El Paso, Texas 79984

343 U.S. Courthouse

P.O. Box 9398

 16

(LOS)

Los Angeles, California 90012

300 North Los Angeles Street

31

 (POO)

Portland, Oregon

Federal Office Building

511 N.W. Broadway

 32

(ANC)

Anchorage, Alaska 99513

New Federal Building

701 C St. RM. D-251

Lock Box 16

 17

(HHW)

Honolulu, Hawaii 96809

P.O. Box 451

595 Ala Moana Blvd.

 18

(PHO)

Phoenix Arizona 85025

Federal Bldg.

230 North First Avenue

 19

(DEN)

Denver, Colorado 80202

1787 Federal Bldg.

1961 Stout St.

 20

(DAL)

Dallas, Texas 75242

Room 6A21, Federal Bldg.

1100 Commerce St.

 21

(NEW)

Newark, New Jersey 07102

Federal Bldg.

970 Board Street

 22

(POM)

Portland, Maine 04112

76 Pearl St.

23

(HAR)

Hartford, Connecticut 6103-3060

Ribicoff Federal Bldg.

450 Main St.

 24

(CLE)

Cleveland, Ohio 44199

Rm. 1917

Anthony J. Celebreeze

Federal Office Bldg.

1240 East 9th St.

 25

(WAS)

Washington, D.C. 20013

25 E Street, N.W.

P.O. Box 37034

 26

(ATL)

Atlanta, Georgia 30303

Rm. 1408

Richard B. Russell

Federal Office Bldg.

75 Spring St., S.W.

 27

(SAJ)

San Juan, Puerto Rico 00936

GPO Box 5068

 28

(NOL)

New Orleans, Louisiana 70113

Postal Service Bldg.

R.M. T-8005

701 Loyola Avenue

 29

(OMA)

Omaha, Nebraska 68102

Federal Office Bldg.

Room 1008

106 South 15th St.

 30

(HEL)

Helena, Montana 59626

Federal Building, Room 512,

Drawer 10036

310 South Park

 38

(HOU)

Houston, Texas 77004

2627 Caroline St.

 39

(SND)

San Diego, California 92188

880 Front Street

 40

(HLG)

Harlingen, Texas 78550

2102 Teege Road

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423515010
DI 23515.010 - Disability Determination Services (DDS) SSA-831 and Notice Completion for Non-Citizen Cases - 08/01/2023
Batch run: 08/01/2023
Rev:08/01/2023